Journal of Modern Medical

Introduction
Medical tourism is one of the emerging forms of health tourism [1]. Globalization in health and health care has been paralleled by emerging trends in providing personalized health care and consumer-driven access to health-related websites [2]. In recent years, media coverage and narrative evidence about these new forms have increased, where people travel outside their country of residence to use medical services [3, 4]. The Internet is changing the way people use health care, the way they obtain information, and the way they evaluate treatment alternatives [5]. There is a need to increase our knowledge of the role of the Internet in facilitating access to treatments; for health care, the Internet offers a wide range of options for accessing information related to diagnosis, follow-up, and support. The main driver is an Internet-based platform for accessing health care information and advertising. Appropriate information leads to the awareness of medical tourists about the current capabilities of health services [6]. One of the research methods online is netnography, which combined qualitative and quantitative techniques and tools to study online consumer culture. This study aims to investigate the effectiveness of the content produced by the website of AriaMedTour Medical Tourism Company, Iran in informing tourists.
Methods
This study was conducted in 2021 using the netnography method. In a netnography, data is collected in three ways: archival data, elicited data, and fieldnotes. The content and advertisements produced on the website of AriaMedTour Medical Tourism Company in Iran (https://ariamedtour.com/intro) were evaluated by analyzing customer comments. After recording 60 comments on the company’s website, the content analysis of the comments was conducted in ATLAS.ti software; based on the results, the effectiveness of the company’s provided information was examined. Then a word cloud of customer comments was created. Finally, the results of theme analysis and word cloud were compared.
Results
Iran is considered one of the important destinations for medical tourism. Many people from neighboring countries have visited Iran for medical issues. Providing correct and timely information for tourists by using different platforms and providing optimal services to them can be beneficial. Those in medical tourism industry should take into account the fundamental role of information for developing effective methods to increase customer retention and maximize income.
Dissection
The findings of the present study were presented in two sections of “website content analysis” and “analysis of customer comments and word cloud”. The content produced by the AriaMedTour company was classified in three categories, relational, organizational and advertising (Table 1).  



Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Hormozgan University of Medical Sciences (Code: IR.Hums.REC.1400.106).

Funding
This study was not funded by any organizations

Authors' contributions
Thematic review of the article and data collection: Azim Zarei; Data analysis and writing the first draft of the article: Maryam Asghari Najib; Editing of the article and final correction of the article: Sima Alipour.

Conflicts of interest
The authors declare no conflict of interest.

References

1. Tonga F, Caglar YS, Aktan ES. Possible early examples of medical tourism. Am J Med Sci. 2021; 362(3):227-32. [DOI:10.1016/j.amjms.2021.05.026] [PMID]
2. Boguszewicz-Kreft M, Kuczamer-Kłopotowska S, Kozłowski A, Ayci A, Abuhashesh M. The theory of planned behaviour in medical tourism: International comparison in the young consumer segment. Int J Environ Res Public Health. 2020; 17(5):1626.‏ [DOI:10.3390/ijerph17051626] [PMID] [PMCID]
3. Lunt N, Hardey M, Mannion R. Nip, tuck and click: Medical tourism and the emergence of web-based health information. Open Med Inform J. 2010; 4:1-11 [DOI:10.2174/1874431101004010001] [PMID] [PMCID]
4. Craigie M, Loader B, Burrows R, Muncer S. Reliability of health information on the internet: An examination of experts’ ratings. J Med Internet Res. 2002; 4(1):e2 [DOI:10.2196/jmir.4.1.e2] [PMID] [PMCID]
5. Bridge M. Medical tourism; The pros and cons [Internet]. The Times. 2007. [Link]
6. Moore A. Health tourism: Don’t forget your toothbrush. Health Serv J. 2009; 119(6139):18-20. [PMID]
7. Miller EA, West DM. Characteristics associated with use of public and private web sites as sources of health care information: Results from a national survey. Med Care. 2007; 45(3):245-51. [DOI:10.1097/01.mlr.0000244509.60556.49] [PMID]
8. Tabibi SJ, Nasiripour AA, Ayubian A, Bagherian MH. [The relation between information mechanisms and medical tourist attraction in Hospitals of Tehran, Iran (Persian)]. Health Inf Manag. 9(3):416-23. https://www.sid.ir/en/Journal/ViewPaper.aspx?ID=403844
9. Kozinets RV. The field behind the screen: Using netnography for marketing research in online communities. J Mark Res. 2002; 39(1):61-72. [DOI:10.1509/jmkr.39.1.61.18935]
10. Ahuja V, Shakeel M. Twitter presence of jet airways-deriving customer insights using netnography and wordclouds. Procedia Comput Sci. 2017; 122:17-24. [DOI:10.1016/j.procs.2017.11.336]
11. Lautier M. International trade of health services: Global trends and local impact. Health Policy. 2014; 118(1):105-13. [DOI:10.1016/j.healthpol.2014.07.004] [PMID]
12. Han H, Hyun SS. Customer retention in the medical tourism industry: Impact of quality, satisfaction, trust, and price reasonableness. Tour Manag. 2015; 46:9-20. [DOI:10.1016/j.tourman.2014.06.003]
13. Hopkins L, Labonté R, Runnels V, Packer C. Medical tourism today: What is the state of knowledge? existing. J Public Health Policy. 2015; 31(2):185-98. [DOI:10.1057/jphp.2010.10] [PMID]
14. Kim S, Arcodia C, Kim I. Critical success factors of medical tourism: The case of South Korea. Int J Environ Res Public Health. 2019; 16(24):4964. [DOI:10.3390/ijerph16244964] [PMID] [PMCID]
15. Park J, Ahn J, Yoo WS. The effects of price and health consciousness and satisfaction on the medical tourism experience. J Healthc Manag. 2017; 62(6):405-17. [DOI:10.1097/JHM-D-16-00016] [PMID]
16. Hu H, Zhang J, Wang C, Yu P, Chu G. What influences tourists’ intention to participate in the Zero Litter Initiative in mountainous tourism areas: A case study of Huangshan National Park, China. Sci Total Environ. 2019; 657:1127-37. [DOI:10.1016/j.scitotenv.2018.12.114] [PMID]
17. Taheri B, Chalmers D, Wilson J, Arshed N. Would you really recommend it? Antecedents of word-of-mouth in medical tourism. Tour Manag. 2021; 83:104209. [DOI:10.1016/j.tourman.2020.104209]
18. Miller A, Smith R, Woods N, Warholak T. Analysis of medical tourism at the Andrade port of entry. J Am Pharm Assoc. 2021; 61(2):e114-9. [DOI:10.1016/j.japh.2020.10.018] [PMID]
19. Cham TH, Cheng BL, Low MP, Cheok JB. Brand image as the competitive edge for hospitals in medical tourism. Eur Bus Rev. 2021; 33(1). [DOI:10.1108/EBR-10-2019-0269]
20. Nilashi M, Samad S, Manaf AA, Ahmadi H, Rashid TA, Munshi A, et al. Factors influencing medical tourism adoption in Malaysia: A DEMATEL-Fuzzy TOPSIS approach. Comput Ind Eng. 2019; 137:106005. [DOI:10.1016/j.cie.2019.106005]
21. De la Hoz-Correa A, Muñoz-Leiva F. The role of information sources and image on the intention to visit a medical tourism destination: A cross-cultural analysis. J Travel Tour Mark. 2019; 36(2):204-19. [DOI:10.1080/10548408.2018.1507865]
22. Najjari H, Didehkhani H, Mostaghimi M, Hosseini SM. Identifying and prioritizing the dimensions of medical tourism with emphasis on technological entrepreneurship. J Health Adm. 2021; 24(1):11-22. [Link]
23. Maxwell JA. Qualitative research design: An interactive approach. California: Sage; 2012. [Link]
24. Belz FM, Baumbach W. Netnography as a method of lead user identification. Creativity Innov Manag. 2010; 19(3):304-13. ‏ [DOI:10.1111/j.1467-8691.2010.00571.x]
25. Kozinets RV, De Valck K, Wojnicki AC, Wilner SJ. Networked narratives: Understanding word-of-mouth marketing in online communities. J Mark. 2010; 74(2):71-89. [DOI:10.1509/jm.74.2.71]
26. Bryman A. Mission accomplished?: Research methods in the first five years of Leadership. Leadership. 2011; 7(1):73-83. [DOI:10.1177/1742715010386864]
27. Kozinets RV. Netnography: Redefined. 2th ed. California: Sage; 2015. [Link]
28. Lincoln YS, Guba EG. Naturalistic inquiry. California: Sage; 1985. [Link]
29. Taufik NA, Sulistiadi W. The impact of medical tourism industry for the hospital services and marketing activities: A systematic review. Jurnal ARSI. 2018; 5(1):42-8. [Link]